| NPI | 1770614919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL F ICKOWSKI Chief Financial Officer 724-357-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: PA 090701) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2024-07-10 |